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Elbow, Forearm and Wrist Injuries in the Athlete

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Summary

Competitive and recreational athletes sustain a wide variety of soft tissue, bone, ligament, tendon and nerve damage to their upper extremities. Most such injuries are related to direct trauma or repetitive stress, and account for a significant amount of ‘down time’ for athletes participating in a wide range of sports, particularly those in which the arm is utilised for throwing, catching or swinging.

Overuse injuries to the elbow include musculotendinous injuries, ulnar nerve injuries and ligamentous injuries. Osteochondrol lesions of the capitellum and posterior impingement injuries in the joint are frequently seen in athletes as well. Acute traumatic injuries to the elbow include tendon ruptures, elbow dislocations and intra-articular fractures.

Forearm overuse injuries in athletes include fracture of the carpal scaphold, fracture of the hook of the hamate, Kienbock’s syndrome and pisoquetral syndromes. ligamentous injuries include scapholunate, lunotriquetral and midcarpal instability injuries. Injuries to the distal radio-ulnar joint and triangular fibrocartilage are also quite common in athletes, and require careful evaluation and treatment.

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References

  1. King JW, Brelsford JH, Tullos HS. Analysis of the pitching arm of the professional baseball pitcher. Clin Orthop 1969; 67: 116

    PubMed  CAS  Google Scholar 

  2. Morrey BF. Tendon injuries about the elbow. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders, 1985: 452–63

    Google Scholar 

  3. An KN, Hui FC, Morrey BF, et al. Muscles across the elbow joint: a biomechanical analysis. J Biomech 1981; 14: 659–69

    Article  PubMed  CAS  Google Scholar 

  4. Hotchkiss RN, Weiland AJ. Valgus stability of the elbow. J Orthop Res 1987; 5: 372–7

    Article  PubMed  CAS  Google Scholar 

  5. O’Driscoll SW, Morrey BF, Bell DF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg Am 1991; 73: 440–46

    PubMed  Google Scholar 

  6. Regan W, Morrey BF. Fractures of the coronoid process of the ulna. J Bone Joint Surg Am 1989; 71: 1348–54

    PubMed  CAS  Google Scholar 

  7. Fleisig GS, Dillman CJ, Escamilla RF, et al. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med 1995; 23: 233–9

    Article  PubMed  CAS  Google Scholar 

  8. Timmerman LA, Andrews JR. Undersurface tear of ulnar collateral ligaments in baseball players: a newly recognized lesion. Am J Sports Med 1994; 22: 33–6

    Article  PubMed  CAS  Google Scholar 

  9. Jobe FW, Elattrache NS. Diagnosis and treatment of ulnar collateral ligament injuries in athletes. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders, 1985: 566–72

    Google Scholar 

  10. Morrey BF, O’Driscoll SW. Lateral collateral ligament injury. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders, 1993: 573–80

    Google Scholar 

  11. Nirschl RP. Muscle and tendon trauma: tennis elbow. In: Morrey BF, editor. The elbow and its disorders. 2nd ed. Philadelphia: WB Saunders, 1993: 537–51

    Google Scholar 

  12. Goldie I. Epicondylitis lateralis humeri (epicondylalgia or tennis elbow): a pathologic study. Acta Chir Scand Suppl 1964: 339

    Google Scholar 

  13. Cabrera JM, McCue FC III. Nonosseous athletic injuries of the elbow, forearm, and hand. Clin Sports Med 1986; 5: 681–700

    PubMed  CAS  Google Scholar 

  14. Gilcreest EL. Ruptures of muscles and tendons. JAMA 1925; 84: 1819

    Article  Google Scholar 

  15. Morrey BF. Tendon injuries about the elbow. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders, 1985: 452–63

    Google Scholar 

  16. Montgomery AH. Two cases of muscle injuries. Surg Clin Chic 1920; 4: 871

    Google Scholar 

  17. Viegas SF. Avulsion of the triceps tendon. Orthop Rev 1990; 19: 533–6

    PubMed  CAS  Google Scholar 

  18. Farrar III EL, Lippert III FG. Avulsion of the triceps tendon. Clin Orthop 1991; 161: 242–6

    Google Scholar 

  19. Tarsney FF. Rupture and avulsion of the triceps. Clin Orthop 1972; 83: 177–83

    Article  PubMed  CAS  Google Scholar 

  20. O’Driscoll SW, Morrey BF, Korinek S, et al. Elbow subluxation and dislocation: a spectrum of instability. Clin Orthop 1992; 280: 17–28

    Google Scholar 

  21. Wood MB, Linscheid RL. Abductor pollicis bursitis. Clin Orthop 1973; 93: 293–6

    Article  PubMed  Google Scholar 

  22. Lapidus PW, Guidotti FP. Stenosing tenovaginitis of the wrist and fingers. Clin Orthop 1972; 83: 87–90

    Article  PubMed  CAS  Google Scholar 

  23. Lipscomb PR. Stenosing tenosynovitis at the radial styloid process (de Quervain’s Disease). Am J Surg 1951; 134: 110–5

    CAS  Google Scholar 

  24. Witt J, Pess G, Gelberman RH. Treatment of de Quervain’s tenosynovitis. J Bone Joint Surg Am 1991; 73: 219–22

    PubMed  CAS  Google Scholar 

  25. Finkelstein H. Stenosing tendovaginitis at the radial styloid process. J Bone Joint Surg 1930; 12: 509–40

    Google Scholar 

  26. Kiefhaber TR, Stern PJ. Upper extremity tendinitis and overuse syndromes in the athlete. Clin Sports Med 1992; 11: 39–55

    PubMed  CAS  Google Scholar 

  27. Eversman WW. Compression and entrapment neuropathies of the upper extremity. J Hand Surg 1983; 8: 759–66

    Google Scholar 

  28. Goodman CE. Unusual nerve injuries in recreational activities. Am J Sports Med 1983; 11: 224–7

    Article  PubMed  CAS  Google Scholar 

  29. Bassett FH, Nunley JA. Compression of the musculocutaneous nerve at the elbow. J Bone Joint Surg Am 1982; 64: 1050–2

    PubMed  Google Scholar 

  30. Rettig AC, Ryan RO, Stone JA. Epidemiology of hand injuries in sports. In: Strickland JW, Rettig AC, editors. Hand injuries in athletes. Philadelphia: WB Saunders, 1992: 37–48

    Google Scholar 

  31. Taleisnik J. Bones of the Wrist. In: Taleisnik J, editor. The wrist. New York: Churchill Livingstone, 1985: 1–12

    Google Scholar 

  32. Ryu J, Cooney WP, Askew LJ, et al. Functional ranges of motion of the wrist joint. J Hand Surg Am 1991; 16: 409–19

    Article  PubMed  CAS  Google Scholar 

  33. Ohnishi N, Ryu J, Chung I, et al. Analysis of wrist motion during basketball shooting. In: Nakamura R, Linscheid R, Miura T, editors. Wrist disorders. Tokyo: Springer Verlag, 1992: 49–55

    Chapter  Google Scholar 

  34. Webber RE, Chao EY. An experimental approach to the mechanism of scaphoid wrist fractures. J Hand Surg Am 1978; 3 (2): 142–8

    Google Scholar 

  35. Coady CM, Mitchell LJ. Stress fractures in the paediatric athlete. Clin Sports Med 1997; 16: 225–38

    Article  PubMed  CAS  Google Scholar 

  36. Reider B, Yurkofsky J, Mass D. Scaphoid waist fracture in a weight lifter: a case report. Am J Sports Med 1993; 21: 329–31

    Article  PubMed  CAS  Google Scholar 

  37. Ganel A, Engel J, Oster Z, et al. Bone scanning in the assessment of fractures of the scaphoid. J Hand Surg Am 1979; 4: 540–3

    PubMed  CAS  Google Scholar 

  38. Cooney WP, Dobyns JH, Linscheid RL. Fractures of the scaphoid: a rational approach to management. Clin Orthop 1980; 149: 90–7

    PubMed  Google Scholar 

  39. Herbert TJ. The fractured scaphoid. St Louis: Quality Medical Publishing Inc, 1990

    Google Scholar 

  40. Herbert TJ, Fisher WE. Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg Br 1984; 66: 114–23

    PubMed  CAS  Google Scholar 

  41. Riester JN, Baker BE, Mosher JF, et al. A review of scaphoid fracture healing in competitive athletes. Am J Sports Med 1985; 13 (3): 159–61

    Article  PubMed  CAS  Google Scholar 

  42. Rettig AC, Weidenbener EJ, Gloyeske R. Management of scaphoid fracture in the athlete. Am J Sports Med 1994; 22: 711–4

    Article  PubMed  CAS  Google Scholar 

  43. Lindstrom A. Fractures distal end of the radius. Acta Orthop Scand 1959; 41: 1–118

    Google Scholar 

  44. Mack GR, Bosse MJ, Gelberman RH, et al. The natural history of scaphoid non-union. J Bone Joint Surg Am 1984; 66: 504–9

    PubMed  CAS  Google Scholar 

  45. Ruby LK, Stinson J, Belskey MR. The natural history of scaphoid non-union: a review of fifty-five cases. J Bone Joint Surg Am 1985; 67: 428–32

    PubMed  CAS  Google Scholar 

  46. Bechenbaugh RD. Noninvasive pulsed electromagnetic stimulation in the treatment of scaphoid nonunion [abstract]. Orthop Transactions 1985; 9: 444

    Google Scholar 

  47. Stark HH, Jobe FW, Boyes JH, et al. Fracture of the hook of the hamate in athletes. J Bone Joint Surg Am 1977; 59: 575–82

    PubMed  CAS  Google Scholar 

  48. Griggs SM, Weiss AC. Bony injuries of the wrist, forearm and elbow. Clin Sports Med 1996; 15: 373–400

    PubMed  CAS  Google Scholar 

  49. Cooney WP, Garcia-Elias M, Dobyns JH, et al. Anatomy and mechanics of carpal instability. Surg Rounds Orthop 1989; 3: 15–24

    Google Scholar 

  50. Ruby LK. Carpal instability: instructional course lectures. Rosemont (IL): American Academy of Orthopaedic Surgeons, 1996: 3–13

    Google Scholar 

  51. Watson HK, Ender MI. Intercarpal arthodesis. In: Green DP, editor. Operative hand surgery: Vol. 1. 1st ed. New York: Churchill Livingstone, 1988: 135–54

    Google Scholar 

  52. Reagan DS, Linscheid RL, Dobyns JH. Lunotriquetrial sprains. J Hand Surg 1984; 9A: 502–14

    Google Scholar 

  53. Lichtman DM, editor. The wrist and its disorders. Philadelphia: WB Saunders, 1988

    Google Scholar 

  54. Lichtman DM, Schneider JR, Swafford AR, et al. Ulnar midcarpal instability: clinical and laboratory analysis. J Hand Surg 1981; 6: 515–23

    CAS  Google Scholar 

  55. Whipple TL, editor. Arthroscopic surgery: the wrist. Philadelphia: B Lippincott, 1992

    Google Scholar 

  56. Whipple TL. The role of arthroscopy in the treatment of wrist injuries in the athlete. Clin Sports Med 1992; 11 (1): 227–38

    PubMed  CAS  Google Scholar 

  57. Taleisnik J. Post-traumatic carpal instability. Clin Orthop 1980; 149: 73–82

    PubMed  Google Scholar 

  58. Taleisnik J, Watson HK. Midcarpal instability caused by malunited fractures of the distal radius. J Hand Surg Am 1984; 9: 350–7

    PubMed  CAS  Google Scholar 

  59. Blatt G. Capsulodesis in reconstructive hand surgery: dorsal capsulodesis for the unstable scaphoid and volar capsulodesis following excision of the distal ulna. Hand Clin 1987; 3: 81–102

    PubMed  CAS  Google Scholar 

  60. Mooney III JF, Siegel DB, Koman LA. Ligamentous injuries of the wrist in athletes. Clin Sports Med 1992; 11 (1): 129–39

    PubMed  Google Scholar 

  61. Koman LA, Mooney III JF, Poehling GG. Fractures and ligamentous injuries of the wrist. Hand Clin 1990; 6: 477–91

    PubMed  CAS  Google Scholar 

  62. Taleisnik J. Soft tissue injuries of the wrist. In: Strickland JW, Rettig AC, editors. Hand injuries in athletes. Philadelphia: WB Saunders, 1992: 227–38

    Google Scholar 

  63. Watson HK, Hempton RF. Limited wrist arthrodesis: I: the triscaphoid joint. J Hand Surg Am 1980; 5: 320–7

    PubMed  CAS  Google Scholar 

  64. Mayfield JK. Patterns of injury to the carpal ligaments: a spectrum. Clin Orthop 1984; 187: 36–42

    PubMed  Google Scholar 

  65. Mayfield JK, Johnson RP, Kilcoyne R. Carpal dislocations: pathomechanics and progressive perilunar instability. J Hand Surg Am 1980; 5: 226–41

    PubMed  CAS  Google Scholar 

  66. Fischer D. Carpal dislocations in the professional football player: presented at the Annual NFL Team Physicians Scientific Symposium. Indianapolis (IN): Feb 12 1991

  67. Palmer AK, Werner FW. Biomechanics of the distal radioulnar joint. Clin Orthop 1984; 187: 26–35

    PubMed  Google Scholar 

  68. Palmer AK, Werner FW, Murphy D, et al. Functional wrist motion: a biomechanical study. J Hand Surg Am 1985; 10 (1): 39–46

    PubMed  CAS  Google Scholar 

  69. Mandelbaum BR, Bartolozzi AR, Davis CA, et al. Wrist pain syndrome in the gymnast: pathogenic, diagnostic, and therapeutic considerations. Am J Sports Med 1989; 17: 305–17

    Article  PubMed  CAS  Google Scholar 

  70. Tolat AR, Sanderson PL, De Smet L, et al. The gymnast’s wrist: acquired positive ulnar variance following chronic epiphyseal injury. J Hand Surg Br 1992; 17: 678–81

    Article  PubMed  CAS  Google Scholar 

  71. Dell PC. Traumatic disorders of the distal radioulnar joint. Clin Sports Med 1992; 11 (1): 141–59

    PubMed  CAS  Google Scholar 

  72. Roth JH, Haddad RG. Radiocarpal arthroscopy and arthrography in the diagnosis of ulnar wrist pain. Arthroscopy 1986; 2: 234–43

    Article  PubMed  CAS  Google Scholar 

  73. Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 1989; 14: 594

    Article  PubMed  CAS  Google Scholar 

  74. Martin DR, Whipple TL, Yates CK. The role of the triangular fibrocartilage complex in distal radioulnar joint stability: a cadaver study. J Hand Surg Am: In press

  75. Osterman AL, Moskow L, Low DW. Soft-tissue injuries of the hand and wrist in racquet sports. Clin Sports Med 1988; 7 (2): 329–48

    PubMed  CAS  Google Scholar 

  76. Zachee B, De Smet L, Fabry G. Arthroscopic suturing of TFCC lesions. Arthroscopy 1993; 9 (2): 242–3

    Article  PubMed  CAS  Google Scholar 

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  1. Methodist Sports Medicine Center, Department of Research and Education, Suite 401, 1815 North Capitol Avenue, Indianapolis, Indiana, 46202, USA

    Arthur C. Rettig

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Rettig, A.C. Elbow, Forearm and Wrist Injuries in the Athlete. Sports Med. 25, 115–130 (1998). https://doi.org/10.2165/00007256-199825020-00004

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